Balancing the Risks & Benefits of Alcohol


The questions and answers about the pros and cons of drinking alcohol have been debated throughout history. How do we define moderation? Why does how much we drink and when (aka drinking patterns) matter? Why do the French, consumers of lots of wine, butter and cheese have lower cardiovascular disease than most? What’s the connection between alcohol and cancer? Do genetics play a role?

Leave it to the Harvard T.H. Chan School of Public Health to put out this largely encompassing piece about the risks and benefits of alcohol, how to balance them and just about everything in between. Read on…

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Throughout the 10,000 or so years that humans have been drinking fermented beverages, they’ve also been arguing about their merits and demerits. The debate still simmers today, with a lively back-and-forth over whether alcohol is good for you or bad for you.

It’s safe to say that alcohol is both a tonic and a poison. The difference lies mostly in the dose. Moderate drinking seems to be good for the heart and circulatory system, and probably protects against type 2 diabetes and gallstones. Heavy drinking is a major cause of preventable death in most countries. In the U.S., alcohol is implicated in about half of fatal traffic accidents. Heavy drinking can damage the liver and heart, harm an unborn child, increase the chances of developing breast and some other cancers, contribute to depression and violence, and interfere with relationships.

Alcohol’s two-faced nature shouldn’t come as a surprise. The active ingredient in alcoholic beverages, a simple molecule called ethanol, affects the body in many different ways. It directly influences the stomach, brain, heart, gallbladder, and liver. It affects levels of lipids (cholesterol and triglycerides) and insulin in the blood, as well as inflammation and coagulation. It also alters mood, concentration, and coordination.

What’s Moderate Alcohol Intake? What’s a Drink?

Loose use of the terms “moderate” and “a drink” has fueled some of the ongoing debate about alcohol’s impact on health.

To read the entire article, click here.


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A New Study Links Alcohol to Unsafe Sex

couple drinking in bedIt will come as no surprise that drinking lots of alcohol often goes hand-in-hand with bad decision making. But up until now, scientists had yet to come up with a direct cause and effect relationship regarding alcohol and unprotected sex.

In the January issue of the journal Addiction, a new study reports that researchers in Canada conducted 12 experiments to test the theory. The results–yes, rather obvious–confirmed that drinking alcohol affects decision-making, and the more alcohol one drinks, the more impaired the decision making. As the results show, for every 0.1mg/mL increase in blood alcohol level, study participants were 5 percent more likely to engage in unsafe sex.

While the findings may not seem overly newsworthy, they do confirm the direct connection between alcohol and sexually transmitted diseases. The study’s conclusion states that  “alcohol use is an independent risk factor for intentions to engage in unprotected sex, and as risky sex intentions have been shown to be linked to actual risk behavior, the role of alcohol consumption in the transmission of HIV and other STDs may be of public health importance.”

“Drinking has a causal effect on the likelihood to engage in unsafe sex, and thus should be included as a major factor in preventive efforts for HIV,” said principal investigator Juergen Rehm of the Centre for Addiction and Mental Health in Toronto, in a statement. “This result also helps explain why people at risk often show this behavior despite better knowledge: alcohol is influencing their decision processes.”

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Media Oversimplifies New Study Linking Alcohol and Breast Cancer

young woman drinking wineOn November 1, the Journal of the American Medical Association (AMA) released a new study, “Alcohol Consumption Over a Woman’s Lifetime Associated with Risk of Breast Cancer.” The study looked at the cumulative effect of low to moderate alcohol consumption among more than 100,000 women, ages 30 to 55, who were followed for 28 years.

In its aftermath, the study results were all over the press with headlines causing a frenzy among women who consume only a couple of glasses of a wine a week. They read:

“Women who drink three to six glasses of alcohol per week have a 15 percent higher risk of getting breast cancer than women who do not drink”

“A Few Drinks a Week Raises Breast Cancer Risk”

“Women: Even a Little Alcohol Ups Breast Cancer Risk, Research Finds”

“Even Small Amount of Alcohol Increases Risk of Breast Cancer”

Although the headlines are not inaccurate, they may be provoking unnecessary alarm. Ten days after the study results were released, the AARP posted an article titled: “Alcohol and Breast Cancer Link: Is Wine Really Bad for Women?” With a subtitle that reads, “The Risk May Not Be As Bad As You Think–or Fear,” the article calls on readers to take a closer look at the study’s statistics before adopting a lifestyle akin to the days of Prohibition.

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Taking a different angle than prior research, this new AMA study looked at the cumulative effect of consuming low to moderate amounts of alcohol. Previous studies linking alcohol and breast cancer risk focused mainly on binge or heavy drinking.

The researchers found that those who drank as few as three to six alcoholic drinks a week during those years had a 15 percent increased risk of breast cancer, compared with those who didn’t drink. And women who regularly drank two or more drinks a day had a 51 percent higher risk than women who never drank.

As the AARP piece explains, “Those numbers — 15 percent increase and 51 percent increase — sound high until you do the math. The average woman’s risk of getting breast cancer in her lifetime is one in eight, or 12 percent. A 15 percent increase over that means her lifetime risk rises to 13.8 percent. For a woman age 50 to 59, whose risk of getting breast cancer while in her 50s is one in 42 or 2.4 percent, according to the National Cancer Institute, her risk rises to 2.76 percent,” the article continues.

So in other words, as Steven A. Narod, M.D., director of familial breast cancer research at the Women’s College Research Institute in Toronto, further clarified in an editorial accompanying the study, for women who had one drink per day, “their 10-year risk increased by 0.7 percent (from 2.8 percent to 3.5 percent).”

Although the risk is real and women need to weigh the risks and benefits of drinking, the ensuing panic may be premature. As reported by the AARP, the study’s authors pointed out in their conclusion: “We did find increased risk at low levels of [alcohol consumption], but the risk was quite small.”

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New Study Says Less Alcohol May Lead to Lower Breast Cancer Rates

A new study published in the June 24 edition of The Journal of the National Cancer Institute revealed that lifestyle changes, such as drinking less alcohol, weight loss, and increased amounts of exercise, could lead to a considerable reduction in breast cancer cases across an entire population, according to a new model that estimates the influence of these variable risk factors.

Often times, breast cancer risk is based on elements that can’t be modified, such as family history. And until now, there have been no models based on ways women can impact their breast cancer risk through lifestyle adjustments.

The findings provide “extremely important information relevant to counseling women on how much risk reduction they can expect by changing behaviors, and also highlights the basic public health concept that small changes in individual risk can translate into a meaningful reduction in disease in a large population,” wrote Dr. Kathy J. Helzlsouer, of Mercy Medical Center in Baltimore, a journal news release.

Using data from an Italian study that included more than 5,000 women, the U.S. National Cancer Institute researchers created the model that included three modifiable risk factors (alcohol consumption, physical activity and body mass index) and five risk factors that are difficult or impossible to modify (family history, education, job activity, reproductive characteristics, and biopsy history).

Benchmarks for some lifestyle factors included getting at least 2 hours of exercise a week (for women 30-39) and having a body mass index (BMI) under 25 (in women 50 and older).

The  authors of the study noted that the predicted changes in lifestyle to achieve significant  changes — such as former and current drinkers becoming non-drinkers — might be overly optimistic.

But the findings, say researchers, may help in designing programs meant to encourage women to make lifestyle changes. For example, a 1.6 percent absolute risk reduction in a general population of one million women amounts to 16,000 fewer cases of cancer.

For information about breast cancer risk, go to the U.S. National Cancer Institute.


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Binge Drinking highest among the wealthy, according to the CDC

The latest estimates to come out of a survey conducted by the Centers of Disease Control reveal that binge drinking–defined as four or more alcoholic drinks per occasion for women and five or more for men–is highest in wealthier adults (with annual household incomes of $75,000 or more) and among high school students. About 33 million Americans are binge drinkers. Most are not alcoholics.

In an piece on these latest findings, Scott Hensley writes, “Now, it’s probably obvious that binge drinking isn’t so good for your health. In the short run drinking like that contributes to accidents and sexual transmission of disease. Keep it up, and there’s liver damage and a higher risk for heart disease and stroke.”

Naturally, these numbers are not to be taken lightly. According to the CDC, binge drinking was the third leading preventable cause of death in the United States and it annually accounted for, on average, approximately 79,000 deaths per year during 2001 and 2005.

The problem, though bad, isn’t much worse than it’s been in recent years. In 1993, the CDC says, about 14 percent of adults had gone on drinking binges. But as Dr. Thomas Frieden, head of the CDC put it, “Because binge drinking is not recognized as a problem, it has not decreased in 15 years.”

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